A case of paradoxical presentation of a postural postdural puncture headache after combined spinal-epidural anesthesia.

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A case of paradoxical presentation of a postural postdural puncture headache after combined spinal-epidural anesthesia.

J Clin Anesth. 2017 May;38:156-157

Authors: Bordlee JW, Beakley BD, Mody R, McConville AP, Weed JT, McClure BP, Foldes PJ, Ma JG, Kaye AD, Eskander JP

Abstract
We report a case of paradoxical presentation of a postural postdural puncture headache secondary to dural puncture with a 25-gauge Whitacre needle for combined spinal-epidural anesthesia. This 27-year-old female patient presented to the emergency department with elevated blood pressure and a global headache 9 days after administration of epidural anesthesia for a spontaneous vaginal delivery after an uncomplicated pregnancy. The patient reported that the headache was more intense when lying down and immediately improved when she sat or stood up from a recumbent position. The patient was discharged from emergency department after an improvement following treatment with labetalol, ondansetron, ketorolac, and fluid resuscitation.

PMID: 28372658 [PubMed - indexed for MEDLINE]

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